Objectives We aimed to evaluate the early effect of continuous treatment with optimum dose of NSAIDs on disease activity and radiographic progression of newly diagnosed axial spondyloarthritis (axSpA). Methods A six-week prospective study on thirty consecutive newly diagnosed active axSpA patients. All patients were assessed at baseline visit, a follow-up visit after 2 weeks, and after 6 weeks of treatment with a continuous optimal dose of NSAID. Assessment included calculation of ASAS NSAIDs index, inflammatory markers, patient`s global assessment, physician's global assessment, quality of life index, as well as pain scale. Disease activity was assessed by determining BASDAI and ASDAS, while functional assessment was evaluated by using BASFI. Spinal mobility was assessed by the mean improvement in BASMI. Magnetic Resonance Imaging of sacroiliac joints was taken at baseline and at the end of the study and was evaluated according to Berlin scoring method. Results We observed improvement in Berlin MRI score, laboratory markers, as well as other clinical parameters including disease activity, spinal mobility, and pain scale. Furthermore, at week 6, ASDAS clinically important improvement and ASAS40 were achieved in 73.3% and 63.3% of patients, respectively. Additionally, BASDI50 was achieved in 30% and 56.7% of patients at week 2 and week 6, respectively. Conclusion A continuous intake of optimal dose of NSAIDs improves not only all clinical indices and inflammatory markers, but also the radiographic signs of activity in axial spondyloarthritis. Moreover, the higher the NSAID index the lower the radiographic progression.